000			03128nam a22003617a 4500
008			240723s20242024 xxu||||| |||| 00| 0 eng d
022			_a2168-8184
024			_aPMC10990875 [pmc]
040			_aOvid MEDLINE(R)
099			_a38576629
245			_aReduced Opioid Use Among Patients Who Received Liposomal Bupivacaine Brachial Plexus Block for Total Shoulder Arthroplasty.
251			_aCureus. 16(3):e55516, 2024 Mar.
252			_aCureus. 16(3):e55516, 2024 Mar.
253			_aCureus
260			_c2024
260			_p2024 Mar
260			_fFY2024
265			_sepublish
265			_tPubMed-not-MEDLINE
520			_aPurpose This retrospective cohort explores the efficacy of regional shoulder blocks using Exparel TM in patients undergoing total shoulder arthroplasty (TSA)/reverse total shoulder arthroplasty (RSA) to reduce total opioid prescription, refills, and length of stay in the acute care setting. Methods Patients who underwent TSA/RSA by a single surgeon in a three-year period were evaluated. Patients in the case group received liposomal bupivacaine 1.3% brachial plexus block while the control group received ropivacaine 0.5% interscalene brachial plexus block. Outcomes of the study included the number of opioids taken, opioids prescribed, and length of hospital stay. Results Thirty-six patients underwent TSA/RSA between January 2017 and March 2020. Patients who received an Exparel brachial plexus block had decreased opioid use within the first 24 hours after surgery compared to the ropivacaine group, 9.00 +/- 14.10 and 26.20 +/- 24.8 morphine milligram equivalent (MME), respectively (p=0.0213). Patients who received an Exparel brachial plexus block had decreased opioid prescriptions over the entire postoperative follow-up, 411.00 +/- 200.74 MME in the case group and 593.07 +/- 297.57 MME in the control group (p=0.0314). Lastly, patients who received an Exparel brachial plexus block had a shorter length of hospital stay, 1.28 +/- 0.91 days as compared to the control group's 2.15 +/- 1.49 days (p=0.0451). Conclusion This study demonstrates a significant reduction in opioid prescribing and use in patients who receive Exparel brachial plexus nerve blocks compared to non-liposomal local anesthetics, as well as a significant reduction in the length of hospital stay. The data suggest that Exparel use may decrease the risks associated with opioid use while providing adequate analgesia in patients undergoing shoulder arthroplasty. Copyright © 2024, Szakiel et al.
546			_aEnglish
650			_zAutomated
651			_aMedStar Washington Hospital Center
656			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
656			_aOrthopaedic Surgery Residency
656			_aOrthopedic Surgery
657			_aJournal Article
700			_aArgintar, Evan _bMWHC
700			_aZittel, Kyle _bMGUH _cOrthopaedic Surgery Residency _dMD
790			_aSzakiel P, Aksu N, Gruber MD, Zittel K, Stryder B, Argintar E
856			_uhttps://dx.doi.org/10.7759/cureus.55516 _zhttps://dx.doi.org/10.7759/cureus.55516
942			_cART _dArticle
999			_c14248 _d14248